Zoonotic Diseases

Diseases discussed here have a history of use as an agent for biological warfare, either in the U.S. or abroad. Its use may have been experimental or actual, and any detrimental consequences upon humans, animals or the environment may have been intentional or not, depending on the circumstances, the point in time, and the nature of the disease.

Thursday, October 6, 2011

Multiple Antibiotic-Resistant Bacterial Crisis in India, Spreading Abroad

Be sure see the info in the link below BEFORE reading this Pro-Med Report, which illuminates for us at least one professional's opinion as to the real source of these bacteria resistant to multi-antibiotics' ;  http://meatsubs.blogspot.com/2011/09/ecoli-bio-engineered.html


NDM-1 CARRYING ENTEROBACTERIACEAE - INDIA (02): NOSOCOMIAL INFECTIONS


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A ProMED-mail post



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International Society for Infectious Diseases





[1] Neonatal ICU

Date: Wed 5 Oct 2011

Source: IBN Live [edited]







India is hosting a global summit on antibiotic resistance in New Delhi

this week [week of 3 Oct 2011], even as the NDM-1 bacterial resistance

factor has now made its way into neonatal ICUs in the country and is

affecting and killing newborn babies.



Because of antibiotic resistance, nearly 60 000 newborn babies are

dying every year in India of sepsis, a treatable blood infection,

despite getting lifesaving antibiotics. "The organisms in the

hospitals have become multidrug resistant. Even the strongest

antibiotics may not work. Invariably, the baby ends up losing the

battle," said Dr Vishal Singh, Sr Consultant, Pediatric Critical Care

Unit, Neonatal ICU.



According to the Public Health foundation of India, one million babies

die every year in India within the 1st 4 weeks of birth, and 190 000

are dying of sepsis, often due to lack of access to medicines, and 30

percent of these deaths are due to antibiotic resistant bacteria.



There is now the threat from NDM-1 containing bacteria, as 4 infants

at a hospital in Birbhum district in rural West Bengal affected with

these bacteria died within 72 hours.



"When we abuse antibiotics or don't use them appropriately, we are

basically strengthening the bacteria that work against these babies,"

said Dr Ramanan of PHFI. "To change this, all we need to do is to use

antibiotics according to prescribed guidelines.



--

Communicated by:

ProMED-mail Rapporteur Mary Marshall





******

[2] General hospital

Date: Wed 5 Oct 2011

Source: India Today [edited]







A study conducted at Delhi's famous Sir Ganga Ram Hospital has found a

worryingly high prevalence of bacteria containing a resistance factor

gene named New Delhi metallo-beta-lactamase 1 (NDM-1). The study,

conducted over the last 5 months, found patients positive for bacteria

containing the antibiotic drug-resistance factor.



A total of 10 889 samples were collected from the hospital. Out of

these, over 2500 positive samples were found in the intensive care

unit (ICU) and around 2700 more in the general ward. The positive

samples came mostly from patients with _E. coli_ infection and

pneumonia. However, doctors at the hospital said that since Ganga Ram

was a tertiary care hospital, patients could already have been

infected when they came to the hospital.



Senior physician and cardiologist Dr K.K. Aggarwal said: "The bacteria

are present. There are 3 studies now which confirm that [they are]

present in the hospitals; they are present in multiple hospitals,

present in India. They are present in water. Now, Ganga Ram says they

are present in their ward. It's a matter of serious concern. All

hospitals should check it, should come out with a new antibiotic

policy, and should absolutely implement hygiene maintenance," Aggarwal

added.



--

Communicated by:

ProMED Rapporteur Mary Marshall





[Originating in India, NDM-1 containing bacteria have spread to the

developed world. As reported in the 25 Jun 2010 Morbidity and

Mortality Weekly Report (2010;59:750), during the 1st half of 2010, 3

isolates of _Enterobacteriaceae_, an _E. coli_, a _Klebsiella

pneumoniae_, and an _Enterobacter cloacae_, were identified at CDC to

carry NDM-1, which confers resistance to all beta-lactams except

aztreonam (a monobactam) and were also resistant to aztreonam. All 3

isolates were from patients who received recent medical care in

India.



Yong and colleagues (Yong D, Toleman MA, Giske CG, et al:

Characterization of a new metallo-beta-lactamase gene, bla-NCm-1, and

novel erythromycin esterase gene carried on a unique genetic structure

in _Klebsiella pneumoniae_ sequence type 14 from India. Antimicrob

Agents Chemother. 2009;53: 5046-54) found that the plasmid carrying

NDM-1 also carries several other resistance genes and appears to

easily transmit itself to other organisms. The authors state that "the

dissemination of this plasmid among clinical bacteria would be a

nightmare scenario."



This NDM-1 gene cassette of wide-spectrum antimicrobial resistance

appears to have developed in the Indian subcontinent, as in the above

report, where the use of antimicrobial agents is quite poorly

controlled. Organisms carrying this resistance combination have

already been introduced into western Europe, the USA, and Canada. The

best methods of control are rapid recognition by standard

microbiologic methodology in patients having the appropriate

medical/travel history and aggressive hand washing techniques.



The amazing overuse of our current antimicrobial armamentarium that I

am currently observing in my clinical practice in the USA will no

doubt serve as an efficient multiplier of these isolates, just as

intravenous drug abuse and sexual promiscuity facilitated the

explosion of HIV 30 years ago. This misuse, in my opinion, is directly

related to the lack of control of antimicrobial usage in intensive

care units and emergency care settings by intensivists and ER

physicians who often react with a lack of wisdom and "cookbook"

protocols instead of using common sense and rational prescribing

patterns. Once the patient moves out of the ICU or ER, the physicians

do not even see the products of their unwise labors.



In the USA, reimbursements for medical care are based on procedures,

not thought processes. Until the power of therapeutic nihilism is

recognized -- that is, using these agents only when rational, in

combinations that make sense, and in settings where therapeutic

interventions can have the ability to produce measurable and

meaningful improvement in a patient's life -- the medical community

will continue down the slippery slope into an era where no therapeutic

options will exist. - Mod.LL]



[see also:

NDM-1 carrying Enterobacteriaceae - India, China: govt. response

20110412.1156

NDM-1 carrying Enterobacteriaceae - India: (New Delhi) water supply

20110411.1145

2010

----

Gram negative bacilli, resistant, update (01): NDM-1, KPC

20101028.3908

NDM-1 carrying Enterobacteriaceae (04): Taiwan ex India 20101005.3604

VIM carrying Enterobacteriaceae - USA ex Greece: 1st rep.

20100922.3422

NDM-1 carrying Enterobacteriaceae (03): worldwide ex India, Pakistan

20100914.3325

NDM-1 carrying Enterobacteriaceae (02): worldwide ex India, Pakistan

20100817.2853

NDM-1 carrying Enterobacteriaceae: N America, UK ex India

20100815.2812]

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